曲美他嗪对冠状动脉介入术后患者B型利尿钠肽及心功能的影响

Effect of trimetazidine on BNP and cardiac function in patients with percutaneous coronary intervention

目的评价曲美他嗪对冠状动脉介入治疗术(PCI)后患者B型利尿钠肽(BNP)及心功能的影响。方法入选拟行冠脉介入术的稳定性或不稳定性心绞痛患者72例,随机分为曲美他嗪组38例和对照组34例,曲美他嗪组PCI术前7 d开始口服曲美他嗪20 mg,每天3次,术后继续服用3个月;所有入选患者给予阿司匹林及常规药物治疗。每例在PCI术前及术后1、3个月分别测定血清B型利尿钠肽(BNP)、超声心动图左室射血分数(LVEF)、NYHA分级。结果术前两组患者血清B型利尿钠肽(BNP)、超声心动图左室射血分数(LVEF)、NYHA分级水平差异均无统计学意义(P>0.05),但PCI术后1、3个月曲美他嗪组BNP较治疗前显著减少(P<0.01),术后1、3个月曲美他嗪组LVEF显著高于对照组(P<0.01)、NYHA分级水平也高于对照组(P<0.05)。结论曲美他嗪可改善PCI术后的左心功能。

Objective To evaluate the effects of trimetazidine（TMZ） on BNP and cardiac function in patients with percutaneous coronary intervention.Methods 72 patients with stable or unstable angina pectoris were randomized to receive trimetazidine（20mg three times a day for 7 days before PCI）（n=38） or keep as controls（without trimetazidine treatment,n=34）.All patients（n=72） were administered aspirin and conventional treatment.The daily routine does was continued for 3 months after PCI.For each patient,clinical efficacy were observed before and 1 or 3 months after PCI,including serum B-type natriuretie peptide（BNP）,left ventricular ejection fraction（LVEF）,NYHA classification.Results Preoperative serum B-type natriuretic peptide（BNP）,ultrasound echocardiographic left ventricular ejection fraction（LVEF） and NYHA classification level were no significant differences between two groups（P0.05）,but compared with the control group,the BNP of trimetazidine hydrochloride group 1 and 3 months after PCI operation were significantly reduced than before treatment（P0.01）,postoperative 1,3 months trimetazidine group,LVEF was significantly higher（P0.01）,NYHA class sub-grade level also was higher（P0.05）.Conclusion Trimetazidine can improve the left ventricular function after PCI.